Pre-Menstrual Syndrom (PMS)
By: Women’S Health
Basic Information
Description
Symptoms that begin seven (7) to fourteen (14) days prior to a menstrual period and usually stop when menstruation begins. About half of all women experience PMS at some time, some very frequently. The peak incidence occurs between ages 25 and 40.
Frequent Signs and Symptoms
• Nervousness and irritability.
• Dizziness or fainting.
• Emotional instability.
• Increased or decreased sex drive.
• Headaches.
• Tender, swollen breasts.
• Bloating, constipation, diarrhea.
• Other digestive disturbances.
• Fluid retention causing puffiness in ankles, hands and face.
• Higher incidence of minor infections such as colds.
• Acne outbreaks.
• Decreased urination.
• Many other symptoms (over 150) have been attributed to PMS.
Causes
Unknown, but may be due to fluctuations in the circulating level of hormones (especially estrogen and progesterone). These fluctuations cause retention of sodium in the blood stream, resulting in edema in body tissues including the brain. Increased levels of prostaglandin (a chemical) in the bloodstream may be a factor. Additional theories about the basis of PMS include psychiatric, endocrinologic, diet, endorphin, serotonin, prostaglandin, fluid retention, vitamin and other factors.
Risk Increases With
• Increased levels of stress.
• Caffeine and high fluid intake seem to worsen symptoms.
• Smoking may also intensify or increase symptoms.
• PMS is exacerbated with age.
• PMS can occur with other disorders such as depression.
Preventive Measures
No specific preventive measures, but try to avoid stressful situations at the expected time of PMS. Also share your feelings and needs with a close friend or spouse.
Expected Outcome
Present treatments may or may not be effective. Medication can relieve some symptoms. However, many new treatments are in the experimental stage, offering hope for the future.
Possible Complications
Emotional stress severe enough to disrupt a woman’s life.
Treatment/Post Procedure Care
General Measures
• A physical examination will be done to rule out other disorders. Diagnosis usually depends on a history of symptoms and their relationship to the menstrual cycle. Keeping a menstrual diary helps monitor and record symptoms and their severity.
• Treatment steps involve education (important to aid in understanding the problem), diet, exercise, and lifestyle changes. There are no medications clearly indicated for PMS.
• Reduce stress where possible. Learn relaxation techniques.
• If feasible, reduce activities during symptomatic days.
• Stop smoking.
• Join a support group. Talking about your PMS problems with others can help.
• Get individual or couple counseling.
• Additional information available from PMS Access, P.O. Box 9326, Madison, WI 53715, (800) 222-4767 (in Wisconsin, 800-833-4767).
Medication
• These are used with varying degrees of success:
• Nonsteroidal anti-inflammatory drugs (NSAIDs) to decrease prostaglandin levels.
• Diuretics to reduce fluid retention.
• Pain medications such as acetaminophen or ibuprofen.
• Vitamin B-6, vitamin E, magnesium.
• Anti-anxiety drugs.
• Danazol for total symptom complex; leuprolide (Lupron) or Gn-Rh (gonadotropin-releasing hormone) where complete ovarian suppression is deemed appropriate.
• Oral contraceptives may help.
• Tranquilizers or sedatives to relieve tension.
• Other medications are undergoing study and may be found to be more effective.
Activity
• Begin a regular, aerobic exercise program (walking, biking, etc.). Exercise appears to help relieve symptoms of PMS.
• Get regular sleep.
Diet
• Decrease salt intake during the premenstrual phase.
• Eat a low-fat, high-complex carbohydrate diet.
• Eat frequent small meals.
• Limit intake of caffeine (coffee, sodas, tea and chocolate).
• Abstain from alcohol.
Notify Your Healthcare Provider If
• You or a family member has symptoms of PMS that interfere with normal activities or relationships.
• Symptoms don’t improve, despite treatment.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
• You or a family member has symptoms of PMS that interfere with normal activities or relationships.
• Symptoms don’t improve, despite treatment.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.